• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

The Menstrual Cup: Does it Work and is it Safe?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • van Eijk et al. (The Lancet, 2019) sought to determine menstrual cup leakage, acceptability, and safety and further assess this product from a public health perspective

METHODS:

  • Systematic review and meta-analysis
  • Search parameters
    • PubMed, Cochrane Library, Web of Science, Popline, Cinahl, Global Health database, Emerald, Google Scholar, Science.gov, and WorldWideScience for studies
    • Manufacturer and User Facility Device Experience database from the FDA
  • Inclusion criteria
    • Quantitative or qualitative studies published in English on experiences and leakage associated with menstrual cups
    • Adverse event reports
  • Primary outcome
    • Menstrual blood leakage when using a menstrual cup
  • Safety outcomes
    • Serious adverse events
    • Vaginal abrasions and effects on vaginal microflora
    • Effects on the reproductive, digestive, or urinary tract
    • Safety in poor sanitary conditions
  • Data analysis
    • Quality and bias assessments performed
    • Preliminary cost estimates and environmental savings vs other products currently available

RESULTS:

  • 43 studies | 3319 participants
    • 15 studies were from low- or middle-income countries
    • Only 3 were moderate to high quality
    • 4 studies made a comparison between menstrual cups and usual products for the main outcome of leakage
  • Reported leakage data was available in 4 studies
    • Cup compared to either usual item used (3 studies) and tampon (1 study)
    • In 3 of the studies there was no difference
    • In 1 study vs tampon, the cup performed better (p=0.041) based on Likert score data over 3 cycles (5.4 vs 4.8)
  • 73% of participants wished to continue use of the menstrual cup at study completion (95% CI, 59 to 84)
  • Adverse events
    • 3 women reported vaginal wounds and 2 severe pain in case reports and could not be confirmed with medical records
    • 6 reported allergies or rashes (one serious, involving silicon allergy)
    • 9 reported urinary tract complaints (3 with hydronephrosis)
  • Infections were not more common among cup users vs those who used other products
    • There were no adverse effects on the vaginal flora
    • 5 reported toxic shock syndrome after use of the menstrual cup with confirmation available for only one case (streptococcus)
      • 2 cases, other relevant conditions reported (e.g., immunodeficiency)
  • Dislodgement of an intrauterine device was reported in 13 women who used the menstrual cup between 1 week and 13 months of insertion of the intrauterine device
  • Professional assistance to aid removal of menstrual cup was reported among 47 cervical cup users and 2 vaginal cup users (mostly via case reports)
  • The authors identified 199 brands of menstrual cup and it was available in 99 countries with prices ranging US $0.72–46.72 (median $23.30)

CONCLUSION:

  • Menstrual cups are a safe and effective option
  • Comparative estimates of toxic shock incidence (approximate)
    • Cup: 0.8 to 3.4 per 100,000 population
    • Tampons (1980 study): 6 to 12 per 100,000 users
    • Authors note risk of toxic shock in women who use barrier methods is also quite low, however adverse events may be under-reported
  • IUDs may be dislodged | Other menstrual products may need to be considered

Learn More – Primary Sources:

Menstrual cup use, leakage, acceptability, safety, and availability: a systematic review and meta-analysis

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

Learn More »

image_pdfFavoriteLoadingFavorite
< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Can Exercise Alleviate Primary Dysmenorrhea?
Can Heat Treat Dysmenorrhea?
Are We Meeting the ACOG Screening Guidelines for Von Willebrand Disease in Adolescents with Menorrhagia?
How Do Combined Hormonal Contraceptives Compare to Other Treatments for Menorrhagia?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site